Restenosis after angioplasty.

A H Gershlick, D P de Bono Coronary angioplasty is now an accepted form of treatment for patients with ischaemic heart disease. In the United States 100 000 procedures were performed in 1988; and in 1990 the procedure will reach parity with coronary surgery. In the United Kingdom just over 5000 procedures were performed in 1988.' It is clear that angioplasty is here to stay and that the indications, particularly in the United Kingdom, will expand. More operators will undertake multivessel, multilesion dilatations, though the results of various comparative trials such as the Coronary Artery Bypass Revascularisation Investigation (CABRI), Randomised Intervention Treat- ment of Angina (RITA), Bypass Angioplasty Revascularisation Investigation (BARI), and Emory Angioplasty Surgery Trial (EAST) may influence patient selection for percuta- neous transluminal coronary angioplasty. The major limitation of this procedure is the high incidence ofrestenosis. Despite increased understanding of the pathophysiology of res- tenosis over the past ten years we are still unable to influence significantly the rate of this complication. The incidence of restenosis varies between 17% and 40%.2' The varia- tion may be the consequence of whether there has been complete angiographic follow up as well as the way that restenosis is defined.